Support for Treatment

A final area for stakeholders to explore is the degree to which treatment
is supported within the broader system of sex offender management. Indeed,
while the effectiveness of interventions is largely a function of the structure
and quality of the existing treatment programs, the potential impact of these
programs cannot be fully realized in the absence of external support. In many
jurisdictions, treatment is mandated for sex offenders, either through legislation,
agency policies, or court orders. However, in and of themselves, treatment
mandates are not necessarily indicative of support. Rather, support for treatment—and
the ways in which that support is demonstrated—depends heavily upon an
appreciation of its value in enhancing community safety.

Another powerful strategy for demonstrating the value
of sex offender treatment is through the use of cost–benefit analyses.

One way to highlight the value of treatment is to engage key stakeholders
in an open and ongoing dialogue about the current empirical evidence for ‘what
works,’ what does not work, and what remains unknown with respect to
sex offender management strategies. Providing an objective and user–friendly
synthesis of the ever–expanding body of treatment effectiveness research
can quickly illuminate the significant impact treatment has on reducing recidivism.
In addition, it can highlight the diversity of the sex offender population
and provide helpful insight into differential risk factors and their influence
on recidivism rates, which ideally emphasizes the potential pitfalls of “one
size fits all” strategies. Furthermore, when the known impact of treatment
for adult and juvenile sex offenders is viewed within the context of the limited
research on other sex offender management strategies, the value of treatment
is drawn into even sharper focus.

Another powerful strategy for demonstrating the value of sex offender treatment,
and thereby garnering support for treatment, is through the use of cost–benefits
analyses. Cost–benefits analyses within the sex offender treatment field
compare the costs associated with providing sex offender treatment against
the tangible costs associated with new reoffenses (e.g., medical and mental
health services for victims, the investigation and prosecution of these cases,
incarceration/placement) (see, e.g., Cohen & Miller, 1998; Donato & Shanahan,
2001; Prentky & Burgess, 1990; Shanahan & Donato, 2001). Researchers
have repeatedly demonstrated that the cost of treatment programs is far outweighed
by the benefits to victims, communities, the courts, and criminal justice systems
(Aos et al., 2001; Cohen & Miller, 1998; Donato & Shanahan, 2001; Prentky & Burgess,
1990; Shanahan & Donato, 2001). In addition to tangible costs for victims,
there are a number of intangible but nonetheless very real costs (e.g., emotional,
psychological, and other internalized effects on victims, families, and communities).
When factored into these analyses, the benefits of treatment increase dramatically
(Donato & Shanahan, 2001; Shanahan & Donato, 2001).

Therefore, treatment providers, researchers, and others should ensure that
legislators and key agency policymakers—particularly those who have responsibility
for allocating resources—have access to this compelling data. And to
bring the point closer to home, state and local agencies should collect treatment
effectiveness data from in–state programs and conduct local cost–benefits
analyses to examine the impact and implications of treatment specific to their
own jurisdictions. This same data can be vital for public education efforts
as a means of garnering additional support for treatment services and other
necessary resources within the community.

As has been emphasized throughout this protocol, multidisciplinary collaboration
and specialized understanding of research about victims, offenders, and management
strategies are vital to supporting evidence–based policies and practices.
The following are just a few examples of how multiple disciplines, entities,
and individuals throughout the system can demonstrate the recognized value
of and ongoing support for sex offender treatment as part of an integrated
approach:

Court support. Prosecutors can ensure that charging decisions
and plea negotiations do not inadvertently undermine treatment, and defense
attorneys can support the success of their clients by eliminating barriers
to the kinds of treatment that can reduce their clients’ likelihood
of recidivating. Judges can become familiar with local resources and use
the leverage of the courts to require treatment and support the involvement
of family members. Court officials can serve as an educators and participants
during treatment conferences, invite treatment providers and researchers
to speak at judicial education events, craft individualized dispositions
that are well–informed by the treatment and other sex offender management
literature, and promote timely responses in instances of non–compliance
with interventions. (For more information about the role that court officers
can play in effective sex offender management, refer to the Investigation,
Prosecution, and Disposition section of this protocol).

Agency support. Corrections, juvenile justice, and community supervision
administrators can embrace a philosophy and culture that supports treatment
and other rehabilitation efforts as a means of enhancing community safety.
This means that administrators and other officials must secure necessary
resources (e.g., staff, program capacity, ongoing funding) that allow programming
to be delivered—and delivered well—by appropriately trained staff.
Indeed, agencies can demonstrate support for quality treatment by ensuring
that treatment staff are well–equipped through specialized pre–service
training, routine on–site clinical supervision, and ongoing continuing
education. Moreover, agency policies and procedures can be designed to promote
informationsharing and collaboration within and across agencies so that all
parties are able to make informed decisions based on complete information.
This can also include the use of common assessment tools to drive treatment
and other case management plans. Finally, as noted previously, when treatment
services are contracted, agencies can use the leverage of the request for
proposals and vendor selection process to require evidence–based and
research–supported interventions, minimum qualifications for treatment
providers, and formal expectations for program monitoring and evaluation.

Public support. Well–informed community members can support
treatment efforts by working with local government officials and agencies
to expand community–based resources for victims and their families,
influencing policymakers to enact rehabilitation–oriented legislation,
serving as members of community support networks for sex offenders, and facilitating
community reintegration by eliminating barriers to employment and housing
so that they are able to access and pay for treatment services. In order
to foster public support, treatment providers and other partners must take
active steps to dispel myths and misperceptions about sex offenders and victims
through community meetings, media outreach, and prevention efforts.

Legislative support. Policymakers can demonstrate support for
treatment by prioritizing funding for prevention efforts and rehabilitative
services within correctional, juvenile justice, and social services agencies,
by allocating resources to fund treatment mandates, and by requiring agencies
to implement evidence–based programs and document outcomes. Legislative
bodies in some states have demonstrated support for treatment efforts by
creating sex offender management boards, endorsing state guidelines, standards,
or certification processes for treatment providers. In addition, they can
partner with researchers and experts in the field of sex offender management
to develop evidence–based policies that can maximize community safety
and minimize the potential for unintended collateral consequences and other
anti–therapeutic outcomes.

Beyond eliciting the support of external stakeholders, treatment providers
themselves can ensure that treatment remains an influential component of a
broader sex offender management strategy in multiple ways, including the following:

Participating on multidisciplinary case management teams as a means of
eliminating unnecessary barriers to critical information–sharing, increasing
transparency regarding the treatment process for other professionals, and
facilitating well–informed and collaborative case management decisions;

Practicing ethically and responsibly, and ensuring the ethical and responsible
practice of colleagues, thereby maintaining the integrity and credibility
of the treatment community overall.

Summary

The treatment of adult and juvenile sex offenders is a key component of a
comprehensive approach. Its value and impact can be maximized when it is available
and accessible on a continuum, driven by research–supported models of
change, focused on variables that are likely to reduce recidivism, individualized
based on assessed risk and needs, delivered by qualified providers in a way
that facilitates engagement, and supported by key stakeholders throughout the
system.